The majority of people who contract COVID-19 do not need treatment and can usually fight the infection themselves. That doesn’t apply to everyone, especially those who are at high risk and have certain health conditions.
To prevent hospitalization and serious illness, several options are available, including antiviral pills and intravenous treatments. Criteria vary widely, and depending on your situation, your doctor may recommend one option over the other.
The Centers for Disease Control and Prevention recommends that those seeking treatment see their doctor, even if they experience only minor symptoms.
As new subvariants continue to spread across the US, here’s what you should know about treatment options, including suitability and possible side effects.
Paxlovid
Paxlovid, the latest treatment garnering widespread attention, is an oral antiviral pill that stops viruses from replicating in the body’s cells and is intended for those currently infected with COVID-19. According to a Yale Medicine article, Paxlovid is available to people ages 12 and older who weigh at least 88 pounds, have a positive COVID-19 test result, have symptoms, and are at high risk of developing severe COVID-19.
In the elderly and other high-risk patients, the drug has been shown to reduce the likelihood of hospitalization or death from COVID-19. The pills work best if taken within five days of the onset of symptoms.
Research suggests that a minority of patients prescribed Paxlovid experience a relapse of the virus, as happened to President Joe Biden. In these cases, symptoms reappeared four or five days after the end of treatment. The CDC said in June that a brief recurrence of symptoms could be a natural part of COVID infection and not related to Paxlovid. According to health officials, no additional treatment is needed for those who experience a rebound.
According to a study in the New England Journal of Medicine, the drug has been shown to reduce the risk of hospitalization in outpatients by 87% when administered as a three-day regimen.
Paxlovid interacts with many different medications, including blood thinners and cholesterol pills. Therefore, make sure your doctor knows your current medication list before discussing any treatment.
molnupiravir
Molnupiravir, also known by the brand name Lageviro, is recommended for people aged 18 and over who are at high risk of hospitalization and death from COVID-19. However, it should only be used when paxlovid, bebtelovimab and remdesivir are unavailable, as its effectiveness has been found to be less than originally reported.
According to Yale Medicine, the drug must be taken as soon as possible, within five days of the onset of symptoms. Merck, the company behind the drug, initially put the effectiveness at 50% but later adjusted it to 30%.
Those prescribed the drug should take four capsules every 12 hours for five days.
Molnupiravir is not recommended during pregnancy because it has not been studied in pregnant women and has shown potential harm in in vitro studies. While the drug is still under investigation and all of the risks may not be known, the most common side effects are diarrhea, nausea, and dizziness.
Other possible treatments
remdesivir
Remdesivir, the first drug approved in late 2020 to treat COVID-19, is the only antiviral treatment to have received full Food and Drug Administration approval — so far, at least. Other treatments, including paxlovid and molnupiravir, are available under FDA emergency use authorization.
Approved for both children and adults, remdesivir is administered intravenously or by injection and must be administered in a medical facility.
To receive treatment, infants and children must be at least 28 days old, weigh over 6.5 pounds, and be either hospitalized or at high risk of serious illness.
While nausea is the most common side effect, post-treatment hypersensitivity, including infusion-related and anaphylactic reactions, has occurred in some cases, according to Yale Medicine. Administered in both outpatient and hospital settings, the drug inserts into new viral genes to block virus replication, shortening the recovery time of critically ill patients.
Monoclonal Antibodies
Although data has shown that not all monoclonal antibody treatments have worked against all COVID-19 variants, some have been deemed effective in combating the Omicron strain.
Bebtelovimab, which was approved in February, is available for adults and children ages 12 and older who weigh at least 88 pounds and are at high risk of developing severe COVID-19. An intravenous injection is given for at least 30 seconds, according to health officials, who said the drug must be administered within seven days of the onset of symptoms.
It is considered an alternative treatment by the National Institutes of Health and should only be used in cases where paxlovid or remdesivir are not available or appropriate.
Another monoclonal antibody, Evusheld, serves a different purpose.
Unlike the above treatments, according to Yale Medicine, it is used to prevent disease in immunocompromised people who do not respond to the vaccine. The drug is available to anyone 12 years and 88 pounds and over and should not be given to anyone with an active infection or anyone who has had recent exposure.
The doses are given into the buttocks during two separate injections, one after the other, with repeat doses every six months. After the injection, hypersensitivity, bruising, swelling, pain and soreness at the injection site are possible.
